Abstract
Based on demonstrated favourable risk-benefit profiles, taxanes remain a key component in the first-line standard of care for advanced non-small-cell lung cancer (nsclc) and nsclc subtypes. In 2012, a novel taxane, nab-paclitaxel (Abraxane: Celgene Corporation, Summit, NJ, U.S.A.), was approved, in combination with carboplatin, for the first-line treatment of locally advanced or meta-static nsclc. The approval was granted because of demonstrated improved antitumour activity and tolerability compared with solvent-based paclitaxel-carboplatin in a phase iii trial. This review focuses on the evolution of first-line taxane therapy for advanced nsclc and the new options and advances in taxane therapy that might address unmet needs in advanced nsclc.
Highlights
Non-small-cell lung cancer is a heterogeneous disease with multiple subtypes, including squamous cell carcinoma, which accounts for 20%–30% of all nsclcs[1,2]
Nab-paclitaxel, a 130-nm albuminbound (“nab”) form of paclitaxel designed to use endogenous albumin pathways to increase intratumoural concentrations of the active drug, demonstrated improved antitumour activity and tolerability compared with sb-paclitaxel when both were used in combination with carboplatin in the first-line treatment of patients with advanced nsclc[12]
The efficacy and safety of sbpaclitaxel–cisplatin and sb-paclitaxel–carboplatin were compared in a large phase iii trial in patients with advanced nsclc[17]
Summary
Non-small-cell lung cancer (nsclc) is a heterogeneous disease with multiple subtypes, including squamous cell carcinoma (scc), which accounts for 20%–30% of all nsclcs[1,2]. Platinum-based doublet regimens, the current standard of care for the treatment of advanced nsclc, yield a 1-year survival rate of 30%–40% and are superior to single-agent therapy[5,6]. Nab-paclitaxel, a 130-nm albuminbound (“nab”) form of paclitaxel designed to use endogenous albumin pathways to increase intratumoural concentrations of the active drug, demonstrated improved antitumour activity and tolerability compared with sb-paclitaxel when both were used in combination with carboplatin in the first-line treatment of patients with advanced nsclc[12]. Based on the results of a phase iii trial, nab-paclitaxel in combination with carboplatin was approved in 2012 as first-line therapy for the treatment of locally advanced or metastatic nsclc in patients who are not candidates for curative surgery or radiation therapy[12,13]. The present review summarizes the clinical experience to date with taxanes in the first-line treatment of nsclc
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